A 32-year-old woman is seen for a follow-up visit with her primary care medical provider for the management of recently diagnosed genital herpes. Routine screening laboratory studies show a negative HIV-1/2 antigen-antibody test, a negative hepatitis B surface antigen (HBsAg), a positive anti-HCV, and a positive HCV RNA. When given the results, she discloses a brief period of injection drug use about 10 years prior. She is told by her provider that she has chronic hepatitis C virus (HCV) infection. She is currently asymptomatic and wants to know how likely it is that she goes on to develop liver cirrhosis.
Without treatment, approximately what percentage of persons with untreated chronic hepatitis C virus (HCV) infection go on to develop cirrhosis after 20 to 30 years?
Figure 1. Time Course of Progression with Untreated Chronic Hepatitis C Infection
This graphic shows the time course for the natural history of chronic hepatitis C infection. Following initial HCV infection, there is typically a lag of 20 to 25 years before cirrhosis develops.
Illustration: David H. Spach, MD
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Question Last Updated
March 11th, 2025
March 11th, 2025
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